Policy Manual sample

MDT Home Health Care Agency, Inc. 89 OSTOMY APPLIANCE CARE PURPOSE: Nurses will provide and instruct the patient in routine care of their ostomy appliance to minimize inconvenience and maximize psychosocial adaptation to altered body image. When ostomy appliance is changed, the stoma and surrounding skin should be assessed for redness, swelling or other irritation/infection. The patient/caregiver should be instructed in s/s to report to agency nurse or physician. Nurse should assess appliance to ensure an appropriate fit. RESPONSIBLE PERSONNEL: RN, LPN EQUIPMENT: ● Ostomy supplies individualized per patient ● Stomahesive paste (optional) ● Stomahesive powder (optional) ● Scissors (if needed to cut to size) ● Soap and water ● Plastic garbage bag ● Toilet tissue ● Gloves ● Skin prep PROCEDURE: There are numerous choices regarding the type of ostomy supplies to be utilized by the patient. Some of the choices include one piece versus two piece system, precut or custom cut. Nurse will adapt teaching to ensure each client or caregiver is capable of performing ostomy care with ordered supplies. 1. Wash hands. Gather equipment (may need to cut flange to size if not precut) 2. Put on gloves. 3. Position patient for comfort and privacy. 4. Remove old flange/bag and dispose in plastic garbage bag. Clean stoma and skin with tissue to remove any stool present. Clean area with soap and water and pat dry 5. Apply skin prep to surrounding skin (as ordered). 6. Apply stomahesive paste in circle around stoma or apply ring of stomahesive paste around opening in flange (as ordered). 7. Center flange opening over stoma and press firmly but gently into place. Hold gentle pressure for 2-3 minutes to allow paste to set. 8. If two piece system, snap bag onto flange and ensure good seal. 9. Ensure clamp is secure on end of bag. 10. Dispose of equipment and remove gloves. 11. Wash hands. DOCUMENTATION: Document date, assessment, procedure performed, patient tolerance and education provided on the Clinical Visit Note. Document patient/caregiver response to teaching. Document any skin irritations and follow up with physician as needed. ____________________________________________________